P-132. Endocarditis in Northeastern Argentina: 10 Years of Hospital-Based Epidemiological Data

TL;DR

This study analyzed 10 years of hospital data on infective endocarditis in northeastern Argentina, highlighting its high mortality and common pathogens.

Contribution

The study provides a detailed 10-year hospital-based epidemiological profile of infective endocarditis in a specific regional context.

Findings

Staphylococcus aureus and Streptococcus spp. were the most common pathogens.

Overall mortality was 38%, with factors like heart failure and persistent bacteremia linked to higher mortality.

Aortic valve was the most frequent site of infection, with most cases involving native valves.

Abstract

Infective endocarditis (IE) is a serious condition with a broad range of clinical manifestations. Despite advances in diagnostic and therapeutic strategies, its morbidity and mortality have not significantly decreased over the years.

We conducted a retrospective, descriptive study of cases meeting the modified Duke criteria for definite IE from 2010 to 2020. Our aim was to describe the clinical and epidemiological characteristics, complications, and mortality among this patient cohort.

A total of 113 patients with definite IE were included. Male sex: 64%. Median age: 48.6 years (range 17–87). Comorbidities: chronic kidney disease 15.8%, heart failure 12.3%, DM 12%. Preexisting cardiovascular conditions: rheumatic heart disease: 9.6%, valvular disease 37.5% and aortic regurgitation 55.5%. IE Localization: aortic valve: 44% (87.7% native), mitral valve: 39.8% (88.8% native), tricuspid valve: 10.6%, pulmonary valve: 0.88%, mural endocardium: 0.88%. Diagnostic modalities: TTE 79%, TEE 81.4%. Microbiological findings: positive blood cultures 86.7%. Most frequent pathogens: Staphylococcus aureus (33.6%), Streptococcus spp. (27.5%) and Enterococcus spp. (16.3%). In-hospital complications: persistent positive blood cultures: 28.3%, persistent fever despite appropriate antibiotic therapy: 26.5%, new neurological events: 23.8%. Surgical management: indication for surgery 57.2%, underwent surgery 75.3% (elective 36.7%, urgent: 32.6%, emergent: 30.6%). Overol mortality: 38%. Device-associated IE mortality: 25%. Factors associated with increased mortality: HF at admission (p = 0.004), persistent bacteremia (p = 0.002), worsening HF (p < 0.0001).

In this 10-year retrospective study, IE affected native aortic valves, with S. aureus and Streptococcus spp. as the most common pathogens. Relatively young median age (48 y) and high overall mortality (38%) reflect the local demographic context and possible delays in diagnosis and treatment. Improving access to early diagnostic tools and specialized care is essential to reduce morbidity and mortality in this setting.

All Authors: No reported disclosures